If it is determined that the severity and clinical signs of vesicoureteral reflux require surgical treatment, there are several common procedures that can be considered. The principle of the surgery is mostly the same, i.e., to create a segment of submucosal ureteral passage to allow the anatomy of the ureterobladder interface to return to normal anatomy. When the bladder fills, urine squeezes this submucosal section of the ureter, temporarily closing the inner lumen of the ureter and acting as a reflux mechanism. The results and success rate of each procedure are the same, 95-99%. The choice of procedure depends on the experience of the surgeon. A surgeon who has more personal experience with the procedure will naturally have fewer complications. Intravesical ureteral reimplantation. After opening the bladder, the ureter is transected, and then a section of the ureter is freed, a submucosal channel is created, the ureter is placed under the mucous membrane, and the ureteral outlet is reanastomosed at the outlet of the channel. The ureteral outlet is done by the Politano-Leadbetter’s procedure with the original outlet, Cohen’s procedure with the new outlet (trans-trigonal, cross-trigonal ), or Glen-Anderson’s procedure (with the new outlet close to the internal urethral opening). The surgery requires incision of the bladder with a new anastomosis. These methods, especially Cohen’s surgery, are popular in China, Hong Kong, the United Kingdom, and Australia (a former Commonwealth country). The most feared complications of this type of surgery are ureteral anastomotic stricture and ureteral torsion or curvature after freeing. Due to the incision of the bladder, a urinary catheter is required after the operation and there will be hematuria for a few days. You can be discharged from the hospital 2-3 days after surgery. Extravesical (outside the bladder) surgery, also known as Lich-Gregoir’s surgery. The procedure involves cutting through a section of the urethral muscle and wrapping it around a section of the ureter, which similarly creates an antireflux mechanism for a section of the submucosal ureter. The advantage is that the bladder does not have to be cut and the ureter does not have to be reanastomosed. It is less disruptive. This procedure is more popular in the United States and some European countries. Since the bladder is not cut and the ureter is not severed, this avoids twisting and narrowing of the ureter. Usually the child can be discharged after 1-2 days. Because the forced urethra muscle is cut, a small number of children (especially those who have bilateral surgery) have slower recovery of bladder function after surgery and need urinary catheters for 2-3 days. 2, minimally invasive surgery: the traditional method of the above two methods is an open surgery entered through a transverse incision in the lower abdomen. At present, some western countries, especially the United States, with robotic (da Vinci) assisted laparoscopy to do these surgeries began to popularize, do the most is Lich-Gregoir’s surgery. Minimally invasive wounds are smaller and recovery should be faster. For low-grade reflux, a filler substance injected submucosally through the cystoscopic ureteral outlet may also be considered abroad, with a slightly lower success rate of 53%-87%. The most popular is a filling substance under the trade name Deflux, which is not currently available in this country. The advantage of this treatment is that there is no wound and the child can be discharged on the same day.The recurrence rate after 2-5 years is 13%.